Accutane is great, the problem is that the NHS prescribe it in way too large doses. They start you off on 30mg a day and gradually increase to double that or even more, dependent on your bodyweight. There's an increasing number of studies and evidence to prove that lower doses are just as effective as these higher doses and "diminishing returns" (when no further benefit is seen beyond a certain dose, only more severe side effects) occur at a pretty low dose of about 20-30mg. I was on prescribed accutane in the past about 5 years ago, and 30mg a day gave me dry and cracked lips and flaky skin that was sun-sensitive. As the dose was increased, I experienced extreme lethargy and severe depression, just used to lay in bed and burst into tears for no reason, totally wasn't myself. It cleared up the acne temporarily, but it returned, albeit not as bad. I tried another course and had the same thing happen.
I'm still acne prone now, and to be totally honest I've been self-prescribing accutane for a while now. I took one tablet every other day for a while and it seriously cleared my skin up without all the side effects. Now I take one tablet every Monday and Friday as a maintenance dose to prevent my skin from producing too much oil, and it just works with no side effects whatsoever. I've had private blood tests done to ensure my liver function, lipids and general health are okay and it's all absolutely fine. Sad state of affairs when I can treat my own acne more efficiently than a qualified dermatologist.